Mother-to-child HIV transmission and its associations among exposed infants after Option B+ guidelines implementation in the Amhara regional state referral hospitals, Ethiopia

Kassaw, Mesfin Wudu; Abebe, Ayele Mamo; Abate, Biruk Beletew; Tlaye, Kenean Getaneh; Kassie, Ayelign Mengesha

doi:10.1016/j.ijid.2020.03.006

Cited by 12 publications

(25 citation statements)

References 16 publications

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“…Although there was no statistical difference in final infant outcomes for mothers who delivered at or outside of health facilities in our study, other studies have reported that delivery in non-health facilities is associated with poor outcomes for infants of pregnant women living with HIV [ 14 , 25 , 41 ], due to lack of skilled birth attendants to ensure safe delivery practices, and the unavailability of PMTCT interventions typically available at health facilities [ 26 ]. Several studies have reported that spontaneous vaginal delivery compared with assisted delivery [ 26 ] or elective caesarean section compared to vaginal delivery [ 20 , 32 ] is associated with negative final infant HIV outcomes, which our study was not designed to evaluate.…”

Section: Discussioncontrasting

confidence: 79%

Final HIV status outcome for HIV-exposed infants at 18 months of age in nine states and the Federal Capital Territory, Nigeria

et al. 2022

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Introduction While antiretroviral therapy (ART) coverage for pregnant women has undergone steady scale-up, Nigeria’s final mother- to-child transmission of HIV (MTCT) rate remains unacceptably high at 10%. This study aimed to determine final outcomes (MTCT rates) and their correlates among HIV-exposed infants (HEI) in nine states and the Federal Capital Territory, Nigeria. Methods This retrospective, cross-sectional study was conducted at 96 primary, secondary and tertiary health facilities supported by the Institute of Human Virology Nigeria. Data was abstracted for a birth cohort of HEI born between October 30, 2014 and April 30, 2015 whose 18–24 month final outcome was assessed by October 30, 2016. Only infants with a six-week first DNA PCR result, and a rapid HIV antibody test result at age 18 to 24 months were included. Multivariate logistic regression (adjusted odds ratios [aORs]) evaluated for predictors of HIV positivity at ≥18 months. Results After testing at ≥18 months, 68 (2.8%) of the 2,405 exposed infants in the birth cohort were HIV-positive. After a minimum of 18 months of follow-up, 51 (75%) HIV-positive infants were alive on ART; 7 (10%) had died, 5 (7.3%) were lost to follow-up and 5 (7.3%) were transferred out. Rural maternal residence, lack of maternal ART/ARV prophylaxis, mixed infant feeding and infant birth weight less than 2.5 kg correlated with an HIV-positive status for infant final outcomes. Conclusion The final HIV positivity rate of 2.8% is encouraging, but is not population-based. Nevertheless, supported by our findings, we recommend continued programmatic focus on early access to quality prenatal care and maternal ART for pregnant women, especially for women living with HIV in rural areas. Furthermore, implementation of nationwide sensitization and education on six-months’ exclusive infant breastfeeding with concurrent maternal ART should be strengthened and sustained to reduce MTCT rates.

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Section: Discussioncontrasting

confidence: 79%

Final HIV status outcome for HIV-exposed infants at 18 months of age in nine states and the Federal Capital Territory, Nigeria

et al. 2022

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“…the same is true for many other developed countries [11]. African countries such as the Ivory Coast [12], Cameroon [13], Mali [14], Malawi [15], South Africa [16], Zambia [17] and Ethiopia [18], Schumann at al., [19] have also had to obtain very low rates of MTCT. some countries have even reported having completely eliminated mother-to-child transmission of the virus [20,21].…”

Section: Discussionmentioning

confidence: 86%

“…Indeed, many studies have reported the existence of several factors that may result in the absence of opportunities for the prevention of vertical transmission of HIV such as the lack of knowledge of the population on the prevention of mother-to-child transmission of HIV, the system of antenatal services and the HIV testing capacity of the institutions, the mode of follow-up [22]. the studies by Kassaw et al [18], Mandelbrot et al [26] have already shown the effectiveness of WHO option B, which recommends the administration of antiretroviral treatment to all HIV-positive pregnant and breastfeeding women, regardless of CD4 cell count or clinical stage. however, in some regions of the world, such as the rural areas considered in this study, the effectiveness of the prenatal consultations recommended by the WHO is still a problem.…”

Section: Discussionmentioning

confidence: 99%

Mother-child HIV-1 transmission in the departments of Mono and Couffo in Benin: incidence and associated factors in 2019

Koudokpon

Dougnon

Kissira

et al. 2020

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Background: Despite worldwide success of introducing HIV testing and treatment with antiretroviral drugs, HIV remains a real public health problem. Vertical mother-child transmission is a form responsible for many cases of new infections. This study was therefore carried out in order to reduce the prevalence of mother-to-child transmission of HIV-1 in the departments of Mono and Couffo. Method: For this purpose, a total of 374 dry blood spots (DBS) were collected from infants born to HIV-positive mothers during the year 2019, and these DBS were used for the molecular diagnosis of HIV1 in these infants. Information on the type of treatment, the type of diet of infants was also collected. The viral loads of the mothers before delivery were determined after the last antenatal visits. To do so, a venous blood sample was taken from an EDTA tube. These different samples were used for DNA extraction. The early diagnosis of these infants as well as the determination of the viral load were carried out by RT-PCR using the Roche automated system. The results were analyzed with the chi-square test on the SPSS software. Result: The results showed that 51% of the newborns included in the study were male and the vast majority of the newborns were in the 0-6 month age group. 93.41% of the newborns included in this study were tested negative for early detection by RT-PCR. Significant links were observed between the early diagnosis of newborns and the mother's mode of feeding, the PMTCT protocol, and the viral load of the mothers. Monoprophylaxis was predominant in the newborn PMTCT protocol (96.28%). Conclusion: The national program for the prevention of vertical transmission of HIV from mother to child deserves to be continued and strengthened with the objective of zero newborns infected at birth in the departments of Mono and Couffo.

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“…Local studies reported from Ethiopia indicated that considerable infants born from HIV positive mother are infected [10][11][12]. For instance, study reported from Amhara regional state has shown 2.3% infants born from HIV positive mother are infected with HIV [11]. An another study reported from Amhara regional state has shown that 10.1% of infants born from HIV positive mother are infected with HIV [12].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence, trend and associated risk factors of Mother-to-Child Transmission of HIV among HIV-exposed infants

Gutema

Hailu

Fikadu

et al. 2022

Preprint

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Background: The Human Immunodeficiency Virus (HIV) Mother-To-Child-Transmission (MTCT) can primarily occur during pregnancy, birth and breastfeeding. However, there is limited recent evidence from large-scale study on MTCT of HIV in Ethiopia. Thus, this study was aimed to determine the prevalence, trend and associated risk factors of MTCT among HIV-exposed infants. Methodology: A cross-sectional study was conducted on 5,679 infants whose specimen referred to Ethiopian Public Health Institute HIV referral laboratory from January 01, 2016 to December 31, 2020. Required information was obtained from Early Infant Diagnosis (EID) database. Frequencies and percent were used to describe the distribution of the infants. Logistic regression analysis was used to identify factors associated with HIV infection. The level of significance was set at 5%. Results: The mean age of the infants was 12.64 (±14.62) weeks with 4 to 72 weeks range. Half of the infants (51.4%) were female. Prevalence of HIV infection over the course of five years among HIV-exposed infants (HEI) was 2.6%. The prevalence of MTCT decreased from 2.9% in 2016 to 0.9% in 2020. After adjusting for covariates; infant testing after six weeks (Adjusted odds ratio (AOR) = 2.7; 95% confidence interval (CI): (1.8–4.0, )) p-value <0.001, absence of Prevention of Mother-To-Child-Transmission (PMTCT) service (AOR = 4.6; 95% CI: (2.9–7.4)) p-values =0.001, mother being on daily prophylaxis at birth (AOR = 2.0; 95% CI: (1.3–3.2)) p-value <0.001, and mother HIV status before date of delivery (AOR =11; 95% CI: (5.5–22.1)) p-value <0.001 were significantly associated with MTCT of HIV. Conclusion: The prevalence of MTCT of HIV is considerable. However, the prevalence was declining during the study period. Tested after six weeks for EID, unavailability of PMTCT service were the factors associated with HIV infection among HEI. Strengthen PMTCT service and early HIV screening of pregnant women are critical to reduce HIV infection among HEI.

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Mother-to-child HIV transmission and its associations among exposed infants after Option B+ guidelines implementation in the Amhara regional state referral hospitals, Ethiopia

Cited by 12 publications

References 16 publications

Final HIV status outcome for HIV-exposed infants at 18 months of age in nine states and the Federal Capital Territory, Nigeria

Final HIV status outcome for HIV-exposed infants at 18 months of age in nine states and the Federal Capital Territory, Nigeria

Mother-child HIV-1 transmission in the departments of Mono and Couffo in Benin: incidence and associated factors in 2019

Prevalence, trend and associated risk factors of Mother-to-Child Transmission of HIV among HIV-exposed infants

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